Peritoneal mesotheliomas mimicking adnexal tumors. Clinicopathological characteristics of four cases and a short literature review

Three cases of peritoneal benign cystic mesotheliomas in women 32-34 years of age and one case of peritoneal malignant mesothelioma in a 47-year-old woman are reported. All cases presented with abdominal discomfort and/or pain and the physical and radiological diagnostic methods showed adnexal tumors. The cystic mesotheliomas developed in the cul-de-sac and the right pelvic side-wall, presented as multiple small cysts or large multilocular cystic mass. The malignant mesothelioma showed extensive infiltration of the omentum the intestinal loops and the surface of the uterus and adnexa, with bilateral hydrosalpinx and ascites. All cases presented histological and immunohistochemical characteristics consistent with tumors of mesothelial origin. No history of asbestos exposure was reported. The correct diagnostic and therapeutic approaches to these neoplasms are discussed.

Mesothelioma; Peritoneum; Immunohistochemistry

[1] Boffetta P.: “Epidemiology of peritoneal mesothelioma: a review”. Ann. Oncol., 2007, 18, 985.

[2] Weiss S.W., Tavassoli F.A.: “Multicystic mesothelioma: an analysis of pathologic. findings and biologic behaviour in 37 cases”. Am. J. Surg. Pathol., 1988, 12, 737.

[3] Lee A.M., Raz D.J., He B., Jablons D.M.: “Update of the molecular biology of malignant mesothelioma”. Cancer, 2007, 109, 1454.

[4] Cutrone R., Lidnisk J., Dunn G., Rizzo P., Bocchetta M., Chumakov K. et al.: “Some oral poliovirus vaccine were contaminated with infectious SV40 after 1961”. Cancer Res., 2005, 65, 10273.

[5] Ross M.J., Welch W.R., Scully R.E.: “Multilocular peritoneal inclusion cysts (so called cystic mesotheliomas)”. Cancer, 1989, 64, 1336.

[6] Robinson B.W., Lake R.A.: “Advances in malignant mesothelioma”. N. Engl. J. Med., 2005, 353, 1591.

[7] Kazan-Allen L.: “Asbestos and mesothelioma: worldwide trends”. Lung Cancer, 2005, 49 (suppl. 1), S3.

[8] Peterson J.T. Jr., Greenberg S.D., Buffler P.A.: “Non-asbestos related malignant mesothelioma. A review”. Cancer, 1984, 54, 951.

[9] Lanphear B.P., Bucher C.R.: “Latent period for malignant mesothelioma of occupational origin”. J. Occup. Med., 1992, 34, 718.

[10] Sugarbaker P.H., Welch L.S., Mohamed F., Glehen O.: “A review of peritoneal mesothelioma at the Washington Cancer Institute”. Surg. Oncol. Clin. N. Am., 2003, 12, 605.

[11] Uzüm N., Ozçay N., Atao lu O.: “Benign multicystic peritoneal mesothelioma”. Turk. J. Gastroenterol., 2009, 20, 138.

[12] Hassan R., Remaley A.T., Sampson M.L., Zhang J., Cox D.D., Pingpank J.: “Detection and quantitation of serum mesothelin, a tumor marker for patients with mesothelioma and ovarian cancer”. Clin. Cancer Res., 2006, 12, 447.

[13] Safioleas M.C., Constantinos K., Michael S., Konstantinos G., Constantinos S., Alkiviadis K.: “Benign multicystic peritoneal mesothelioma: a case report and review of the literature”. World J. Gastroenterol., 2006, 12, 5739.

[14] Feldman A.L., Libutti S.K., Pingpank J.F., Bartlett D.L., Beresnev T.H., Mavroukakis S.M. et al.: “Analysis of factors associated with outcome in patients with malignant peritoneal mesothelioma undergoing surgical debulking and intraperitoneal chemotherapy”. J. Clin. Oncol., 2003, 21, 4560.

[15] Taub R.N., Hesdorffer M.E., Keohan M.L.: “Combined resection, intraperitoneal chemotherapy, and whole abdominal radiation for malignant peritoneal mesothelioma (MPM)”. J. Clin. Oncol., 2005, 23, 664s.

[16] Scagliotti G.V., Novello S.: “State of the art in mesothelioma”. Ann. Oncol., 2005 16 (suppl. 2), 240.